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General NPI Number Information
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NPI Number | 1518677145
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Entity Type | Individual
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Provider Name | PRINCESS LLYAN LALATAG RBT
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Gender | Female
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 7995 BLUE DIAMOND RD STE 102
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City | LAS VEGAS
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State | NV
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Zip | 89178-9408
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Country | US
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Telephone | 702-848-6070
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Fax |
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Provider Business Mailing Address
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Address Line | 9405 S EASTERN AVE APT 2105
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City | LAS VEGAS
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State | NV
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Zip | 89123-3997
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Country | US
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Telephone | 808-464-8509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT3084
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License Number State | NV
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